Pramipexole, a non-ergolinic, D3-preferring dopamine agonist (DA), is well established as a treatment option for motor symptoms at all stages of Parkinson's disease (PD). It is administered orally and is available as both a three-times daily immediate-release (IR) formulation and a once-daily extended-release (ER) formulation (Mirapex(®) ER, Mirapexin(®) ER; Pexola(®) ER, Sifrol(®) ER). The two formulations are bioequivalent; the majority (>80 %) of patients can be switched overnight from pramipexole IR to ER without the need for dosage adjustment...

Patel T, Chang F. Parkinson's disease guidelines for pharmacists. Can Pharm J (Ott) 2014;147:161-170. (Original DOI: 10.1177/1715163514529740). Several clarifications have been made to Table 2 of the above article. The updated information below has been added to the original table available online at cpjournal.ca. Entacapone (Comtan)COMMENTS: Adjunctive treatment with levodopa; liver function test as neededPramipexole (Mirapex)DOSAGE: Extended release not available in CanadaRopinirole (Requip)DOSAGE: Extended release not available in CanadaCarbidopa/levodopa controlled release (Sinemet CR)DOSAGE: When converting from IR to SR formulation: Increase total daily levodopa dose by 10%; titrate based on clinical response, administer in divided doses 2 or 3 times daily[This corrects the article on p...

Disorders of initiation and maintenance of sleep (DIMS), excessive daytime sleepiness (EDS) are common and clinically significant in patients with Parkinson's disease (PD). The aim of the study was the evaluation of the effects of the dopamine agonist pramipexole on DIMS and EDS in PD. Sixty-seven patients with PD (mean age 63.2+/-9.9 years old, mean illness duration 6.5+/-4.2 years) were enrolled in the study. Forty patients received pramipexole as add-on to the other antiparkinsonian medications in mean daily dosage 2...

The open 6-month study (the MIRAG study) on the effect of D2/D3 dopamine agonist pramipexole (mirapex) on tremor, affective disorders and quality of life in patients with Parkinson's disease (PD) was carried out. Ninety-eight patients, aged from 42 to 75 years (mean age 63.2+/-10.2 years) were included in the study. Scores on the Hoehn and Yahr scale varied from 1 to 4 (mean 2,5+/-0,8). Seventy percent of patients received levodopa in average dose 351.2+/-279.4 mg; 62% of patients had motor fluctuations and 43% had dyskinesias...

Forty-five patients with Parkinson's disease (PD) without dementia were studied. Duration of disease was 6,02+/-3,47 years. The following scales were used: PFS-16, UPDRS part 2, the Beck Depression Scale, PDSS and the Epworth Sleepiness Scale. Fatigability is thought to be one of three presentations of PD that restrict daily activities in 64% of patients. The integrated assessment of fatigability was significantly correlated with the total depression score and PDSS scores. The treatment with mirapex resulted in the reduction of fatigability that was not correlated with changes in motor functioning, depression, sleep disorders...

Ropinirole hydrochloride (REQUIP, ADARTREL) and pramipexole dihydrochloride (MIRAPEX, SIFROL) are two putative dopamine D(3) receptor subtype-selective agonists recently approved by the FDA for the treatment of 'restless legs syndrome' (RLS). RLS is a difficult to define condition that is possibly more prevalent than previously thought. Direct-to-consumer advertising has raised public and professional awareness of RLS, but questions, even skepticism about the very existence of the condition, persist. The drugs have adverse effects that can negatively impact on quality of life and thus, as true for all drugs, require consideration of the benefit : risk ratio...

The open 3-month study of influence of D2/D3 dopamine agonist pramipexole on of Parkinson's disease (PD) features, which are relatively resistant to traditional dopaminergic therapy: tremor, affective and cognitive impairment, has been conducted. Ninety-eight patients with PD, aged from 42 to 75 years (mean age 63,2+/-10,2 years), have been included in the study. Twenty percents of patients included were older than 70 years. The Hoehn and Yahr stage varied from 1 to 4 (men stage 2,5+/-0,8). Seventy percents of patients received levodopa (mean dosage 351,2+/-279,4 mg); 62% had motor fluctuations and 43% - dyskinesias...

An aim of a study was to establish the relationship between pain, motor complications and depression in Parkinson's disease and evaluate an effect of the 3 months therapy with the dopamine receptor agonist pramipexole (mirapex). Seventy-eight patients with idiopathic parkinsonism, aged 56-73 years, including 18 patients in stage 1-1,5 of the disease; 31 patients - in stage 2; 20 patients - in stage 3 and 9 patients - in stage 4, were studied. A stable response to the therapy was observed in 28 patients, motor complications in 50...

Developing effective treatments for chronic neurodegenerative disorders such as amyotrophic lateral sclerosis (ALS) has proven extremely difficult. ALS is universally fatal, characterized by progressive weakness due to the degeneration of upper and lower motor neurons, and leads eventually to respiratory failure which is the usual cause of death. Only a single treatment has been approved, the modestly effective nonspecific neuroprotectant Rilutek (riluzole; 2-amino-6-(trifluoromethoxy)benzothiazole). KNS-760704 [(6R)-4,5,6,7-tetrahydro-N6-propyl-2,6-benzothiazole-diamine dihydrochloride, RPPX], a synthetic amino-benzothiazole with demonstrated activity in maintaining mitochondrial function, is being developed as a treatment for ALS...

The effect of the dopamine receptor antagonist mirapex on emotional disorders (anxiety, depression), cognitive disturbances and sleep disorders has been studied in 66 patients with Parkinson's disease. Mirapex has been administered in addition to levodopa and other antiparkinsonian drugs in dosage 3,5+/-1,1 mg daily to 36 patients with emotional and cognitive disorders and in dosage 2,9+/-0,96 mg daily to 30 patients with sleep disorders. Patient's state has been assessed using a number of psychometric scales and neuropsychological tests...

We present a review of the literature on dopamine receptor agonists along with our own data on the treatment of Parkinson's disease (PD) with Mirapex, which was used in 30 patients (mean age 61.8 +/- 7.7 years, duration of disease 8.4 +/- 1.3 years). Mirapex was used at a dose of 3.5 +/- 1.1 mg/day on the background of treatment with levodopa preparations. The efficacy of Mirapex was assessed using quantitative scales. Improvements were demonstrated in general state, motor activity, daily activities, and the quality of life...

The results of mirapex (pramipexol) treatment of 402 patients with Parkinson's disease and juvenile parkinsonism during the period from 6 months to 7 years are summarized. Mirapex was used in monotherapy as well as in combination with levadopa and other antiparkinsonic drugs. The drug was well tolerated and effective in rest tremor, hypokinesia, muscle rigidity and depression, the more pronounced effect being seen at the early stage of the disease. The use of mirapex allows an effective control of motor fluctuations developing during long-term continuous levodopa therapy...

Presented are our own results, along with literature data on dopamine receptors agonists, of Parkinson's disease (PD) therapy with mirapex. Thirty patients with PD (mean age 61,8 +/- 7,7 years, illness duration 8,4 +/- 1,3 years) were treated with mirapex in a mean dose 3,5 +/- 1,1 mg/day and levadopa. Mirapex efficacy was assessed with a number of quantitative scales. Mirapex improved patient's global state, movement and daily activity, and quality of life. The authors drew attention to the decrease of motor fluctuations expression and dyskinesias as well as anxiety, depression, cognitive dysfunction...

Parkinson's disease is a neurodegenerative disorder with a growing social significance. Currently, dopamine agonists are considered as first-line medication used before levodopa treatment. High cost of dopamine agonists makes it necessary to estimate their cost efficacy by means of pharmacoeconomical studies. We studied efficacy of mirapex evaluated by UPDRS and PDQ-39 scores before and after 1-year treatment in 44 patients with Parkinson's disease: 18 patients non-pretreated with levodopa and 26 patients pretreated with levodopa...

Levodopa should generally be avoided early in the course of Parkinson disease; dopamine agonists, particularly second-generation agents such as ropinirole (Requip) and pramipexole (Mirapex), carry a smaller long-term risk of dyskinesia and should be used instead. Deep brain stimulation is remarkably effective in refractory cases and may well usher in a new era in the treatment of chronic neurologic disease.

The purpose of this paper was to examine the effects of speech therapy and various pharmacological treatment approaches on the voice and speech of persons with Parkinson s disease (PD). Approximately 80% of PD patients have voice and speech problems including reduced vocal intensity, reduced vocal pitch, monopitch and monoloudness, and imprecise articulation. Research prior to 1970's had not demonstrated significant improvements following speech therapy. However, recent research has shown that speech therapy (when persons with PD are optimally medicated) has proven to be the most efficacious therapeutic method for improving voice and speech function...

Parkinson's disease (PD) is a common neurodegenerative disorder characterised by selective loss of dopaminergic neurones in the substantia nigra and resulting in progressive disability. Therapy has focused on replacing depleted dopamine (DA) via supplementation with levodopa or DA agonists. Pramipexole (Mirapex), Pharmacia Corp.) has recently been approved for the treatment of PD. Evidence from preclinical studies and clinical trials have proven the effectiveness of this agent in ameliorating the symptoms of PD...

The binding of the D2-like agonists, (+)-7-hydroxy-N,N-di-n-[3H]propyl-2-aminotetralin (7-OH-DPAT) and [3H]pramipexole (2-amino-4,5,6-tetrahydro-6-propylaminobenzthiazole; MIRAPEX) were determined in membranes from adult male Sprague-Dawley and Fischer-344 rats. Saturation analysis, which optimized binding to D3 receptors, revealed 3-6 fold differences in Bmax values between the two radioligands with no change in affinity. [3H](+)7-OH-DPAT labeled 41.4+/-4.1 to 61.8+/-3.0 fmol/mg protein in nucleus accumbens and striatal homogenates, yet [3H]pramipexole labeled only 7...